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Special Considerations for Long-Term Survivors After Solid Organ Transplantation

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Transplant Infections

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Abstract

Survival from solid organ transplantation has improved markedly over the last few decades due to progress in surgical techniques, newer antibiotics, and more effective immunosuppression. While short-term complications have decreased with improved management there remains an important focus on the long-term complications. These long-term complications include both infectious and non-infectious issues which will limit further improvement in graft and patient survival. The infectious causes mostly include community-acquired bacterial and viral infections. The metabolic and cardiovascular complications are prominent amongst non-infectious causes of long-term morbidity being driven by additional risk factors like effects of immunosuppression that increase the risk for hypertension, obesity, renal failure, and diabetes. Chronic immunosuppression leads to a higher incidence of most malignancies particularly skin cancers and these neoplastic processes appear to have an accelerated course in this population. Post-transplant lymphoproliferative disorder is a neoplasm related to EBV infection that is unique to the immunosuppressed population. A systematic health maintenance regimen which includes vaccinations, management of cardiovascular risk factors, and cancer screening will ensure that the long-term transplant survivors will be able to avoid significant morbidity and mortality from these complications.

The original version of this chapter was revised. An erratum to this chapter can be found at https://doi.org/10.1007/978-3-319-28797-3_54

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Change history

  • 21 March 2018

    An erratum has been published.

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Authors and Affiliations

  1. Lung Transplant, Division of Pulmonary, Allergy and Critical Care, Duke University Hospital, 330 Trent Drive, Hanes House, Duke, NC, 27710, USA

    Hakim Azfar Ali M.D., F.C.C.P.

  2. Department of Medicine, Duke University Medical Center, 103002, Suite 2073 MSRB-2, 106 Research Drive, Duke, NC, 27710, USA

    Scott M. Palmer M.D., M.H.S.

  3. Infectious Diseases Service and Transplantation Center, University Hospital of Lausanne, CHUV, Rue de Bugnon 21, Lausanne, 1011, Switzerland

    Oriol Manuel M.D.

Authors
  1. Hakim Azfar Ali M.D., F.C.C.P.
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  2. Scott M. Palmer M.D., M.H.S.
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  3. Oriol Manuel M.D.
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Correspondence to Hakim Azfar Ali M.D., F.C.C.P. .

Editor information

Editors and Affiliations

  1. Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

    Per Ljungman

  2. Tufts University School of Medicine Tufts Medical Center, Boston, MA, USA

    David Snydman

  3. University of Washington Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Michael Boeckh

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© 2016 Springer International Publishing Switzerland

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Ali, H.A., Palmer, S.M., Manuel, O. (2016). Special Considerations for Long-Term Survivors After Solid Organ Transplantation. In: Ljungman, P., Snydman, D., Boeckh, M. (eds) Transplant Infections. Springer, Cham. https://doi.org/10.1007/978-3-319-28797-3_53

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  • DOI: https://doi.org/10.1007/978-3-319-28797-3_53

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  • Online ISBN: 978-3-319-28797-3

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